Abortion Law Reform, Health, Fertility, and Socioeconomic Well-Being: A Critical Synthesis of Causal Evidence

This article examines the relationship between abortion law reform, effective access to abortion care, and maternal, infant, reproductive, and socioeconomic outcomes. The evidence base comprises 55 indexed research publications and complementary methodological literature spanning liberalization, restrictions, financial coverage, clinical provision, and the denial of a wanted abortion. Rather than interpreting heterogeneous policy changes as a single treatment, the synthesis distinguishes population-level effects of laws from individual-level effects of receiving or being denied care. Findings from historical event studies, difference-in-differences, synthetic controls, longitudinal cohorts, instrumental-variable designs, international models, and systematic reviews are considered alongside null and adverse results. Evidence most directly supports the clinical safety of recommended abortion care and the importance of effective access; several quasi-experimental studies identify improvements in maternal health and reductions in financial hardship, while results for aggregate maternal mortality, infant outcomes, education, fertility, and intimate partner violence depend on population, timing, and measurement. Contemporary mortality estimates remain imprecise, and live-birth selection complicates the interpretation of infant statistics. No common pooled effect is estimated because interventions, estimands, outcomes, and samples are not sufficiently interchangeable. An explicit framework is developed for causal appraisal, sensitivity analysis, evidence synthesis, and policy evaluation in Latin America